Provider Demographics
NPI:1255306007
Name:MID-AMERICA UROLOGY, PA
Entity Type:Organization
Organization Name:MID-AMERICA UROLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-780-3388
Mailing Address - Street 1:10550 QUIVIRA RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2306
Mailing Address - Country:US
Mailing Address - Phone:913-948-8365
Mailing Address - Fax:913-541-1034
Practice Address - Street 1:10550 QUIVIRA RD
Practice Address - Street 2:SUITE 270
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-948-8365
Practice Address - Fax:913-541-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CS3061OtherRAILROAD MEDICARE
MO4630000AMedicare PIN
CS3061OtherRAILROAD MEDICARE